Symptoms associated with teething

Abstract

Objective To conduct a large, prospective study of healthy infants to determine which symptoms may be attributed to teething, and attempt to predict tooth emergence from an infant s symptoms. Design Prospective cohort of 125 well children in a clinic-based paediatric group practice. Outcome measures Parents recorded daily two tympanic temperatures, presence or absence of 18 symptoms and all tooth eruptions in their infants, from the 4-month well-child visit until the child turned 1 year old. Results Daily symptom data were available for 19 422 child-days and 475 tooth eruptions. Symptoms were only significantly more frequent at 4 days before a tooth emergence, the day of emergence and 3 days after. Increased biting, drooling, gum-rubbing, sucking, irritability, wakefulness, ear-rubbing, facial rash, decreased appetite for solid foods and mild temperature elevation were all statistically associated with teething. Congestion, sleep disturbance, stool looseness, increased stool number, decreased appetite for liquids, cough, rashes other than facial rashes, fever over 102°F and vomiting were not significantly associated with tooth emergence. Although many symptoms were associated with teething, no symptom occurred in >35% of teething infants, and no symptom occurred >20% more often in teething than in non-teething infants. No teething child had a fever of 104°F and none had a life-threatening illness. Conclusion Many mild symptoms previously thought to be associated with teething were found in this study to be temporally associated with teething. No symptom cluster, however, could reliably predict the imminent emergence of a tooth. Before caregivers attribute to teething any infant's signs or symptoms of a potentially serious illness, other possible causes must be ruled out.